NPI | 1841325057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 30870) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 30870) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 30870) | |
103TF0200X Psychologist, Forensic (Licence: TX 30870) | |
Enumeration Date | 2007-02-21 |
Last Update Date | 2007-07-08 |